Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
POUDRE VALLEY HEALTH CARE INC
 
Employer identification number
84-1262971
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) UCHEALTH MEDICAL GROUP
2315 E HARMONY RD 200
FT COLLINS,CO80528 		80-0348943 501(C)(3) 37,692,615       SEE SCH I, PART IV
(2) UNIVERSITY SCHOOL OF MEDICINE
13001 17TH PLACE
AURORA,CO80045 		84-6000555 501(C)(3) 5,287,942       SEE SCH I, PART IV
(3) UCHEALTH NORTHERN COLORADO FOUNDATION
2315 E HARMONY RD 200
FT COLLINS,CO80528 		74-1894581 501(C)(3) 945,197       SEE SCH I, PART IV
(4) FRONT RANGE COMMUNITY COLLEGE FOUNDATION
3645 W 112TH AVENUE
WESTMINSTER,CO80031 		38-3721881 GOVERNMENT 21,596       SEE SCH I, PART IV
(5) FOOD BANK OF LARIMER COUNTY
1301 BLUE SPRUCE DRIVE
FORT COLLINS,CO80524 		74-2336171 501(C)(3) 20,603       SEE SCH I, PART IV
(6) UNITED WAY OF WELD COUNTY
PO BOX 1944
GREELEY,CO80632 		84-6011918 501(C)(3) 10,302       SEE SCH I, PART IV
(7) CITY OF FORT COLLINS
300 WEST LAPORTE AVE
FORT COLLINS,CO80522 		84-6000587 GOVERNMENT 17,277       SEE SCH I, PART IV
(8) ESTES PARK HEALTH FOUNDATION
555 PROSPECT PARK
ESTES PARK,CO80517 		74-2411016 501(C)(3) 19,436       SEE SCH I, PART IV
(9) COLORADO ROCKIES FOUNDATION
2001 BLAKE ST
DENVER,CO80205 		84-1178557 501(C)(3) 12,266       SEE SCH I, PART IV
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
9
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS BASED ON THE BENEFIT TO THE COMMUNITY. THE ORGANIZATION REQUESTS INFORMATION FROM THE GRANTEES TO ENSURE THAT THE FUNDS WILL BE USED FOR THE SPECIFIED PURPOSE. QUESTION I, PART II, COLUMN H PURPOSE OF GRANT OR ASSISTANCE FOR RELATED ENTITIES, THE GRANTS ARE RELATED TO SPECIFIC REQUESTS. THE FUNDS ARE TO BE USED TO BENEFIT THE HEALTHCARE COMMUNITY OF NORTHERN COLORADO. EACH REQUEST IS EVALUATED ON AN INDIVIDUAL BASIS. FOR NON-RELATED COMMUNITY AND GOVERNMENTAL ORGANIZATIONS, THE GRANTS ARE MADE AT THE DISCRETION OF THE ORGANIZATION. THESE DISCRETIONARY GRANTS ARE TO BE USED TO BENEFIT THE HEALTHCARE COMMUNITY OF NORTHERN COLORADO.
Schedule I (Form 990) 2020



Additional Data


Software ID:  
Software Version: